Abstract：
BACKGROUND: Although platelet indices are routinely available using automated blood cell counters, the clinical applications of these parameters for malaria and dengue hemorrhagic fever (DHF) have not been substantially implemented. We conducted this study to investigate the potential role of platelet indices as a prognostic marker in adult patients with Plasmodium vivax malaria, Plasmodium falciparum malaria, and DHF admitted to the Hospital for Tropical Diseases, Bangkok, Thailand.
METHODS: We enrolled 219 eligible patients, comprising 96 with P. falciparum malaria, 71 with P. vivax malaria, and 52 with DHF. We evaluated the study groups\' baseline clinical features and alterations of platelet indices during the first 4 days of admission.
RESULTS: Upon admission, the initial laboratory findings showed no statistically significant difference in platelet count (PC), plateletcrit (PCT), or platelet distribution width (PDW) between patients with P. vivax and P. falciparum; however, mean platelet volume (MPV) was significantly higher in patients with P. falciparum. Comparisons of the initial platelet indices in malaria and DHF showed that only PC and PCT were significantly lower in DHF. Although MPV in DHF tended to be lower than in malaria, a statistically significant difference was observed only with P. falciparum. Moreover, the results also showed no significant alterations in the platelet indices among the study groups during the first 4 days of admission.
CONCLUSIONS: Clinical presentations of DHF and malaria are nonspecific and may overlap with other common tropical diseases. Alterations of initial platelet indices may be investigated in P. vivax and P. falciparum malaria mimicking DHF. Although a significant reduction in PC and PCT in DHF might be a clue for differential diagnosis of malaria, the use of MPV and PDW might be impractical. We suggest that appropriate laboratory diagnoses for malaria and dengue infections are still needed for the differential diagnosis of acute febrile patients who have a risk of malaria or dengue infections. To clarify the clinical utility of platelet indices in patients with dengue and malaria, further studies are required that particularly include patients with different severities, geographical areas, and levels of health care settings.
METHODS: We enrolled 219 eligible patients, comprising 96 with P. falciparum malaria, 71 with P. vivax malaria, and 52 with DHF. We evaluated the study groups\' baseline clinical features and alterations of platelet indices during the first 4 days of admission.
RESULTS: Upon admission, the initial laboratory findings showed no statistically significant difference in platelet count (PC), plateletcrit (PCT), or platelet distribution width (PDW) between patients with P. vivax and P. falciparum; however, mean platelet volume (MPV) was significantly higher in patients with P. falciparum. Comparisons of the initial platelet indices in malaria and DHF showed that only PC and PCT were significantly lower in DHF. Although MPV in DHF tended to be lower than in malaria, a statistically significant difference was observed only with P. falciparum. Moreover, the results also showed no significant alterations in the platelet indices among the study groups during the first 4 days of admission.
CONCLUSIONS: Clinical presentations of DHF and malaria are nonspecific and may overlap with other common tropical diseases. Alterations of initial platelet indices may be investigated in P. vivax and P. falciparum malaria mimicking DHF. Although a significant reduction in PC and PCT in DHF might be a clue for differential diagnosis of malaria, the use of MPV and PDW might be impractical. We suggest that appropriate laboratory diagnoses for malaria and dengue infections are still needed for the differential diagnosis of acute febrile patients who have a risk of malaria or dengue infections. To clarify the clinical utility of platelet indices in patients with dengue and malaria, further studies are required that particularly include patients with different severities, geographical areas, and levels of health care settings.
摘要：
背景：尽管使用自动血细胞计数器可以常规获得血小板指数，这些参数在疟疾和登革出血热（DHF）的临床应用尚未得到实质性实施。我们进行了这项研究，以探讨血小板指数作为成年间日疟原虫疟疾患者的预后标志物的潜在作用。恶性疟原虫疟疾，DHF住进了热带病医院，曼谷,泰国。
方法：我们招募了219名符合条件的患者，包括96例恶性疟原虫疟疾，71例间日疟原虫疟疾，52和DHF。我们评估了研究组在入院前4天的基线临床特征和血小板指数的变化。
结果：入院时，最初的实验室检查结果显示血小板计数（PC）没有统计学上的显着差异，plateletcrit（PCT），或间日疟原虫和恶性疟原虫患者之间的血小板分布宽度（PDW）；然而，恶性疟原虫患者的平均血小板体积（MPV）明显较高。疟疾和DHF的初始血小板指数的比较表明，DHF中只有PC和PCT显着降低。尽管DHF的MPV倾向于低于疟疾，仅在恶性疟原虫中观察到统计学上的显着差异。此外，结果还显示,在入院前4天,各研究组的血小板指数无显著变化.
结论：DHF和疟疾的临床表现是非特异性的，可能与其他常见的热带疾病重叠。可以在模拟DHF的间日疟原虫和恶性疟原虫疟疾中研究初始血小板指数的变化。尽管DHF中PC和PCT的显着降低可能是疟疾鉴别诊断的线索，MPV和PDW的使用可能是不切实际的。我们建议，仍然需要对疟疾和登革热感染进行适当的实验室诊断，以鉴别诊断有疟疾或登革热感染风险的急性发热患者。阐明血小板指数在登革热和疟疾患者中的临床应用,需要进一步的研究，特别是包括不同严重程度的患者，地理区域,和卫生保健设置的水平。
方法：我们招募了219名符合条件的患者，包括96例恶性疟原虫疟疾，71例间日疟原虫疟疾，52和DHF。我们评估了研究组在入院前4天的基线临床特征和血小板指数的变化。
结果：入院时，最初的实验室检查结果显示血小板计数（PC）没有统计学上的显着差异，plateletcrit（PCT），或间日疟原虫和恶性疟原虫患者之间的血小板分布宽度（PDW）；然而，恶性疟原虫患者的平均血小板体积（MPV）明显较高。疟疾和DHF的初始血小板指数的比较表明，DHF中只有PC和PCT显着降低。尽管DHF的MPV倾向于低于疟疾，仅在恶性疟原虫中观察到统计学上的显着差异。此外，结果还显示,在入院前4天,各研究组的血小板指数无显著变化.
结论：DHF和疟疾的临床表现是非特异性的，可能与其他常见的热带疾病重叠。可以在模拟DHF的间日疟原虫和恶性疟原虫疟疾中研究初始血小板指数的变化。尽管DHF中PC和PCT的显着降低可能是疟疾鉴别诊断的线索，MPV和PDW的使用可能是不切实际的。我们建议，仍然需要对疟疾和登革热感染进行适当的实验室诊断，以鉴别诊断有疟疾或登革热感染风险的急性发热患者。阐明血小板指数在登革热和疟疾患者中的临床应用,需要进一步的研究，特别是包括不同严重程度的患者，地理区域,和卫生保健设置的水平。
